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A �' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)4/13/18 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTNAME:ACT Meghan Christy <br /> Markel Service Incorporated rvc°°.No.Ext): (678)290-3819 (A/C,No): <br /> 4600 Cox Road ADDRESS: Meghan.Christy@clubinsurance.com <br /> Glen Allen,VA 23060 PRODUCER <br /> CUSTOMER ID#: l D 1 3257 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Markel Insurance Company 38970 <br /> Vicki Venolia INSURER B: <br /> 2313 113th Dr SE#A INSURER C: <br /> Lake Stevens,WA 98258 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 1044603 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/YLIMITS <br /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDYYY) <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100,000 <br /> CLAIMS-MADE • OCCUR X FTG6562-02 7/3/18 7/3/19 MED EXP(Any one person) $5,000 <br /> A X Professional Liability PERSONAL 8 ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $3,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 <br /> 41/ POLICY ri JEa n LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED Ill SCHEDULED <br /> AUTOS I I AUTOS BODILY INJURY(Per accident) $ <br /> HIRED AUTOS NON-OWNED <br /> AUTOS PROPERTY DAMAGE $ <br /> (Per accident) <br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITYY I N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) <br /> Certificate Holder is included as an Additional Insured per the Blanket Additional Insured Endorsement <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Everett SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> The Carl Gipson Senior Center of Everett THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 3025 Lombard ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Everett,WA 98201 <br /> AUTHORIZED REPRESENTATIVE <br /> L_ <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />